A Research Protocol for Evaluating Sustainable Medical Practices in Southern Africa: A Case Study from the Republic of Congo

Sustainable medical practices are essential for resilient healthcare systems. The Republic of Congo faces specific challenges in maintaining obstetric and gynaecological services due to resource constraints. There is a need to identify and evaluate locally developed, sustainable practices within this setting. This protocol describes a study to evaluate sustainable practices within obstetric and gynaecological services in the Republic of Congo. Its objectives are to catalogue existing sustainable practices, assess their perceived efficacy and feasibility from staff and patient perspectives, and identify barriers and enablers to their implementation and scaling. A mixed-methods, convergent parallel design case study will be conducted at a major referral hospital in Brazzaville. Quantitative data on resource use and clinical outcomes will be collected from routine hospital records. Qualitative data will be gathered via focus group discussions with healthcare staff and semi-structured interviews with postpartum women. Data will be analysed using thematic analysis for qualitative data and descriptive statistics for quantitative data. As this is a protocol, no empirical findings are available. Anticipated findings include a detailed catalogue of sustainable practices and qualitative themes regarding their implementation. Preliminary scoping suggests many adaptations may relate to reusable equipment and task-shifting. The study is expected to provide a framework for understanding context-specific sustainable practices in low-resource obstetric and gynaecological settings, highlighting the realities of sustaining care with limited conventional resources. Expected recommendations will likely focus on integrating successful local practices into policy, investing in training for sustainable techniques, and developing strategies to scale effective interventions to similar regional settings. sustainable medicine, obstetrics, gynaecology, low-resource settings, implementation research, Republic of Congo, mixed methods. This protocol contributes a structured approach to investigating locally developed sustainable practices, aiming to generate evidence to inform service delivery and policy in low-resource obstetric and gynaecological care in Southern Africa.